Health Encyclopedia

Cholangiocarcinoma

Definition

Cholangiocarcinoma is the growth of cancer cells in the bile duct. The bile duct are a number of branching tubes that carry bile from the liver to the gallbladder and small intestine. Bile is a fluid that helps digest food and eliminate waste from the body.

Cholangiocarcinomas can be divided by their location:

Perihilar—develops at the point where the branches of the bile duct join and leave the liver (most common form)

Intrahepatic—develops in the bile duct branches that are located in the liver

Distal—develops in the area of the bile duct that is closer to the small intestine

Causes

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.

Defects on specific genes may lead to the growth of cancer cells in the bile duct. Other causes may be related to a combination of genetics and environment.

Risk Factors

Cholangiocarcinoma is more common in people 65 years and older. Other factors that may increase your chance of cholangiocarcinoma include:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Blood tests will help to evaluate how the liver and gallbladder are working. These tests may also help to find tumor marker, indicators of cancer in the body.

Imaging tests can evaluate the bile duct and surrounding structures. These may include:

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, cholangiocarcinoma is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Treatment

The treatment plan depends on the stage of the cancer and your overall health.

Surgery

Surgery may be done to try to remove the cancer. The bile duct reaches into many organs. Surgery may involve more than one organ. For example:

Perihilar bile duct cancer—may include the removal of part of the liver, bile duct, and gall bladder

Intrahepatic bile duct cancer—may include the removal of part of the liver or an entire lobe

Distal bile duct cancer—may include the removal of part of the pancreas and small intestine

If the cancer cannot be removed, other types of surgery may be done to relieve symptoms. A small tube may be placed inside of a cancerous bile duct to allow bile to flow through it.

Radiation Therapy

Radiation therapy
is used to kill cancer cells and shrink tumors. Different forms include:

External radiation therapy—radiation directed at the tumor from a source outside the body

Internal radiation therapy—radioactive materials placed into the body in or near the cancer cells

Radiation may be done along with surgery. It may also be the main treatment if cancer cannot be removed.

Chemotherapy

Chemotherapy
is the use of drugs to kill cancer cells. This treatment may be used before or after surgery. If the tumor cannot be removed, chemotherapy may be given, either alone or in combination with radiation therapy.

Clinical Trials

Clinical trials may be recommended if treatment options are limited for your type of cancer. These trials could offer treatments that are not currently available to most. Talk to your doctor about these options.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.